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EAST TEXAS MEDICAL CENTER CANCER INSTITUTE NPI 1023121522


NPI Information

NPI: 1023121522
Provider Name: EAST TEXAS MEDICAL CENTER CANCER INSTITUTE

Other Name: ETMC CANCER INSTITUTE

Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
721 CLINIC DR
TYLER, TX
ZIP 75701
Phone: (903) 595-5550
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EAST TEXAS MEDICAL CENTER CANCER INSTITUTE is a radiation oncology radiology in Tyler, TX. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. EAST TEXAS MEDICAL CENTER CANCER INSTITUTE NPI is 1023121522. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Etmc Cancer Institute.

The provider's business location address is:

721 CLINIC DR
TYLER, TX
ZIP 75701-043
Phone: (903) 595-5550

The provider's authorized official is Byron Hale .
The authorized official title is Cfo and has the following contact phone number (903) 535-6215.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 8/6/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0001XRadiologyRadiation OncologyTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100SN36MEDICARE PINTEXAS
2085049701MEDICAIDTEXAS
3P00627400MEDICARE PIN
400SN36OTHERTEXASBCBS OF TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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